BMI Matters: Predicting Cardiovascular Event Risk

While various epidemiological studies have shown obesity to be linked with inflammation and with increased cardiovascular risk, the inflammatory marker C-reactive protein (CRP) takes it a step further, strongly predicting the incidence of cardiovascular events.

While various epidemiological studies have shown obesity to be linked with inflammation and with increased cardiovascular risk, the inflammatory marker C-reactive protein (CRP) takes it a step further, strongly predicting the incidence of cardiovascular events.

Whether CRP is equally predictive of cardiovascular event risk in obese patients and in non-obese subjects is not known and will be addressed in a presentation by Christoph H. Saely, MD, VIVIT Institute, Academic Teaching Hospital, Feldkirch, Austria at the American College of Cardiology (ACC) 64th Annual Scientific Meeting.

During a follow-up 10-year period, the researchers recorded cardiovascular events in a large population of 1,731 patients undergoing coronary angiography — evaluating the established or suspected stable coronary artery disease (CAD).

CRP was reported significantly higher in non-obese subjects (n=1,367) than obese individuals (n=364; 0.6±1.5 vs. 0.5±0.8 mg/dl; p<0.001). Meanwhile, approximately a quarter of the patients were reported to have suffered vascular events.

While CRP appeared to be a strong, independent predictor of vascular events in non-obese subjects, it did not show similar results in the obese group. However, an interaction term of BMI x CRP was found to be significant, demonstrating that the mass index weight considerably modified the power of CRP to predict vascular events.

“From the results of this large 10-year prospective cohort study we conclude that obesity significantly modulates the power of CRP to predict cardiovascular event risk among angiographied coronary patients,” wrote the authors.